methylcellulose and Colitis--Ulcerative

This article gives an overview of the possibilities of conventional radiography in the diagnosis of inflammatory bowel disease of the small intestine and colon.. For more than 25 years we examine the small bowel employing enteroclysis with barium and methylcellulose and the colon with the usual double-contrast method. In the last 152 months 1560 small bowel enemas were performed. In the last 40 months 410 examinations of the colon were performed.. There is a thirty percent decrease in enteroclysis examinations within the past 5 years,however, the rate of examinations with positive results increased from 46 to 57%. The proportion of the inflammatory small intestinal diseases (not only Crohn's disease) remained constant with 18%.Concerning the examinations of the colon for inflammatory disease we confirmed the diagnosis in seven cases. The radiation exposure for the enteroclysis in inflammatory diseases was 7 mSv, for colon examinations 14 mSv.. Barium examinations, especially of the stomach and colon are decreasing in frequency. Therefore the art of performance and interpretation might get lost.Enteroclysis, however, is still the method of reference for the other imaging methods. The advantages compared to the other imaging methods are the excellent presentation of the details of the mucosal surface and the observation of functional disorders.

Topics: Barium Sulfate; Colitis, Ulcerative; Contrast Media; Crohn Disease; Diagnosis, Differential; Enema; Humans; Ileal Diseases; Inflammatory Bowel Diseases; Methylcellulose; Radiography; Time Factors; Tuberculosis, Gastrointestinal

Although ileal pouch-anal anastomosis is the procedure of choice for most patients with ulcerative colitis or familial adenomatous polyposis, most patients have problems with stool frequency and/or consistency. Although most clinicians recommend fiber supplementation for these patients, we could find no studies that prove the efficacy of this practice. The first purpose of this study was to document the effect of fiber supplementation on intestinal function in patients after ileal pouch-anal anastomosis. Because pectin, a soluble fiber supplement, has been reported to slow gastric and intestinal transit, we also hypothesized that pectin would be a superior fiber supplement in these patients. The second purpose, therefore, was to determine whether the effects of pectin on intestinal transit would result in decreased stool frequency in patients with an ileal pouch.. Thirteen patients who had undergone ileal pouch-anal anastomosis for ulcerative colitis were entered into a 9-wk crossover study. The protocol consisted of three 2-wk study periods, each of which was preceded by a 1-wk washout period. During the three study periods patients supplemented their diets, in random order, with Citrucel, 1 tablespoon twice daily; pectin, 1 tablespoon twice daily; or no supplement. Patients maintained detailed dietary and bowel function diaries.. The effects (mean +/- SE) of Citrucel and pectin supplementation are summarized in Table 1. There was no significant effect of either supplement on stool frequency, pouch function, bloating, or stool consistency. In addition, there were no differences in continence.. We found no evidence to support the common practice of fiber supplementation in patients with an ileal pouch. Furthermore, this study did not find that stool frequency decreased during supplementation with pectin. We conclude that there is little role for fiber supplementation in patients with an ileal pouch.

Topics: Adult; Chronic Disease; Colitis, Ulcerative; Cross-Over Studies; Defecation; Diet Records; Dietary Fiber; Female; Gastrointestinal Motility; Humans; Intestines; Male; Methylcellulose; Middle Aged; Pectins; Proctocolectomy, Restorative

Three layered pellets of budesonide were prepared for colon delivery by the extrusion-spheronization method. The coatings consisted of hydroxypropylmethyl cellulose (HPMC) (as barrier layer), Eudragit E (as rate controlling layer) and hydroxypropylmethyl cellulose acetate succinate (HPMC AS) (as enteric layer). The rate controlling layer was further modified using various pore formers. Dissolution studies were carried out at pH 1.2, 7.4 and 6.8. Pellet core composition and type and level of pore former affected the drug release from pellets. Pellets containing 20% (m/m) citric acid in the cores coated with HPMC at a coating level of 6% (m/m), Eudragit E containing Avicel RC 581 (30%) as pore former at a coating level of 30% (m/m) and HPMC AS at a coating level of 15% (m/m) had the best release profiles. These pellets showed promising results in alleviating the conditions of an experimental model of colitis induced by trinitrobenzenesulfonic acid in rats.

Topics: Animals; Anti-Inflammatory Agents; Budesonide; Cellulose; Chemical Phenomena; Citric Acid; Colitis, Ulcerative; Colon; Drug Compounding; Drug Delivery Systems; Excipients; Hydrogen-Ion Concentration; Lactose; Male; Methylcellulose; Particle Size; Rats; Rats, Wistar; Solubility; Tablets, Enteric-Coated

Assessment of 3 different rectal contrast agents (water, methylcellulose, ultrasound gel) for their suitability for colorectal imaging in multislice CT (MS-CT).. 115 patients with colorectal diseases underwent MS-CT with varying, rectal contrast agents in a prospective study. Images were assessed by 2 independent CT-experienced radiologists. 6 criterias were evaluated, using a 5-point scale.. Methylcellulose (MC) proved to be significantly superior to ultrasound gel (US). Especially, differentiation of healthy and diseased bowel and bowel wall and lumen were aided, which was proven by quantitative analysis of attenuation values. Rectal distension is greater using MC or US than for water. More proximal parts of the colon could be better distended with water. The interobserver correlation was good (kappa 0.76).. Rectal filling with MC significantly improves diagnostic confidence in colorectal examinations. Ease of administration and lack of problems suggest its use as a clinical routine tool.

Topics: Adult; Aged; Aged, 80 and over; Colitis, Ulcerative; Colonic Diseases; Colorectal Neoplasms; Contrast Media; Crohn Disease; Female; Gels; Humans; Male; Methylcellulose; Middle Aged; Observer Variation; Prospective Studies; Radiography, Abdominal; Rectal Diseases; Tomography, X-Ray Computed; Water